Frat parties, football teams, and college bars were all petri dishes for fresh COVID-19 outbreaks this summer, and public health experts are warning that we’ll see even more as campuses around the country reopen this fall.
And there will be a whole new hot spot thrown into the mix: dorms.
The college campus has emerged as the latest setting for the confusion, fear, and politics of the US coronavirus outbreak. Filled with close living in dorms, young people who enjoy partying, and older at-risk staff, colleges pose a risk comparable to past disease outbreaks on cruise ships and in prisons.
“We don't know if things are going to necessarily get better. Or get worse,” Emory University epidemiologist Robert Bednarczyk told BuzzFeed News, offering this piece of advice to students: “Be prepared to be flexible because we don't know what's going to happen.”
As college administrators nationwide have this month announced reopening plans, their chief guidance has been a CDC “considerations” document updated on June 30. It calls for “promoting behaviors that reduce spread, maintaining healthy environments, maintaining healthy operations, and preparing for when someone gets sick,” all within the confines of a regular schedule of on-campus virus tests to nip outbreaks in the bud.
Still, “it’s not going to be 100% safe, even if all the mitigation steps are taken,” Crystal Watson of the Johns Hopkins Center for Health Security, a coauthor of a June guide to reopening for college administrators, told BuzzFeed News. The simple reality is that the pandemic will still be raging in the fall, and that COVID-19 is an infectious respiratory disease most commonly spread by indoor exposure to infected people for lengths of time shorter than most college lectures — a disease that most of humanity has no immunity to.
“You obviously have to have a plan in place to get infections down, or you are going to see exponential growth in cases,” University of Washington epidemiologist Carl Bergstrom told BuzzFeed News, “which could get ugly fast.”
“If colleges don’t have a plan, they have no business reopening.”
Colleges and universities across the country have a plethora of plans, almost all moving either heavily or completely online. Harvard’s decision to go fully online highlighted a curious paradox — one of the nation’s perceived highest-status universities embracing the operating plan of traditionally online schools like the University of Phoenix.
Still, the nation's 50 largest college and university groups — which serve more than 2.7 million of the nation’s more than 6.3 million college students — are offering some form of live instruction, including the massive Lone Star College System in Texas and big state schools like Arizona State, the University of Texas, and Michigan State. About 44% of those 2.7 million students are being offered “hybrid” classes with a mixture of virtual and in-person instruction. Another 21% of those students are attending schools that are continuing face-to-face education.
Hybrid arrangements vary across institutions. Many involve reduced-occupancy classrooms driven by the need for individual 6-foot spacing, streaming or prerecorded classes, and less crowded dorm rooms, with triple rooms becoming doubles and doubles becoming singles. Labs and other hands-on classes continue. Most require masks and 6-foot-spacing rules, a requirement highlighted by the University System of Georgia backing down from making masks optional rather than required in classrooms.
“I don’t feel this plan is safe,” University of Illinois archaeology professor Lisa Lucero told BuzzFeed News, as she prepares for hybrid classes on a campus of more than 50,000 students.
“Staggering classes, extending times classes, teaching on Saturdays, etcetera, are great ideas, but it will still be crowded parts of the time,” said Lucero. “The only reasonable, safe thing is to plan for online teaching for the fall semester, period. The issue would then be tuition and fee reductions — which is a conversation I think universities’ administrators don’t want?”
“I am torn,” she added. “I really feel for students, especially first-year undergraduates and graduate students. But we are living in crazy times.”
In a wider survey of more than 1,100 schools, but which doesn’t account for enrollment numbers, the Chronicle of Higher Education has found about 58% of them will have students return to campus. Compared against the top 50 enrollment schools, where only around 21% emphasize in-person classes, that suggests a lot of smaller schools are aiming to keep instruction in the classroom, a place seen as a key virus transmission point of concern in most plans.
What is certain is that the pandemic, now responsible for more than 3 million confirmed cases and over 133,000 deaths in the US, takes hallmarks of college life and turns them into outbreak risks.
You don’t need an expert to tell you college students are going to go to parties, pandemic or not.
So university leaders need to think about how their policies could encourage gatherings in more confined spaces, sociologist Arielle Kuperberg of UNC Greensboro, an expert on risk-taking behavior in college students, told BuzzFeed News.
For many students, “college is the time to break free of your parents, and go out and party and break all these boundaries, and take risks,” Kuperberg said.
“So if [administrators] don't address that or talk about it and just assume, ‘there's a pandemic now and people are gonna go to college, but they're gonna behave totally different,’” she said, “that’s not going to go so well.”
The University of Washington, where Bergstrom, the epidemiologist, teaches, emerged as the setting for one of the summer’s early warning college outbreaks. At least 142 students tested positive — as of Tuesday — after an outbreak at a fraternity house. Frat parties are likewise blamed for 47 cases at the University of California, Berkeley, in the last week alone.
That’s why schools that try to outright ban booze or partying might instead spur drinking and rule-breaking — both Kuperberg, and, well, common sense say — driving gatherings to confined, indoor spaces where outbreaks are more likely.
A more sensible course would be to try to offer students ways to reduce the risks of the inevitable. That might mean allowing outdoor parties, as fresh air settings are widely seen as safer, or residential assistants leading Zoom socializing sessions to keep everyone connected.
For all the concern about students partying, most of them really don’t want to get anyone sick, social epidemiologist Alison Cohen of the University of California, Berkeley, who led a spring coronavirus attitudes survey of 725 college students, told BuzzFeed News. More than half of them started social distancing in college this spring before any state shutdown orders. Only a third had attended gatherings of more than 50 people since March, and more than a quarter thought April’s stay-at-home restrictions should remain in force until a vaccine is available, something not foreseen even optimistically until after the fall semester ends.
“Many students took social distancing seriously,” Cohen said by email. “And so there is reason for optimism.”
Dorms are notorious incubators of shared illnesses, helping spread stomach bugs, influenza, and vaccine-preventable diseases such as measles and mumps.
The Diamond Princess cruise ship coronavirus outbreak in February first triggered alarm about dorm life. In an April study, the University of Maryland’s infectious disease investigator, Donald Milton, examined infections in residence halls tracked 120 students and reported that respiratory disease rates were four times lower in dorms that were ventilated with outdoor air, rather than recirculated, filtered air. In a February interview, Milton told BuzzFeed News that cracking windows to let in fresh air and giving students space heaters to keep their rooms warm was safer than letting central heating systems recirculate viruses in dorms. That’s more expensive, of course, but safer.
Universities are aiming to educate students about long-neglected hygiene steps as conditions for living in dorms this fall. (One 2009 study found that only a third of women and about half of men in dorms washed their hands after peeing, for example.) The gigantic Ohio State University, with an enrollment of 66,000, is asking students to take the “Buckeye Pledge” to abide by social distancing measures and wash and sanitize their hands, while signing what some feared was a liability waiver if they get sick. On the small side, Reed College’s 1,400 students will be offered an “addendum” to their housing contract that promises to offer the same strictures.
But that’s not enough, Kuperberg said, meaning residence halls will have to be actively cleaned by universities in a way that hasn’t been seen before.
Essentially, universities will have to make it easy for students to keep their housing clean, Watson, the environmental engineer coauthor on the Johns Hopkins guide to campus reopenings, said. That means making cleaning supplies easy to find, increased disinfection schedules for residences, and plenty of signs and reminders. Reed College has raised the possibility of housing students in “pods” defined by their areas of study to limit the exposure to infected people across the entire campus.
The big requirement is for students to stay in bed if they feel sick rather than go to class. Cohen’s survey found 30% of students went to class even when they had COVID-19 symptoms this spring, though that mostly happened before people understood the dangers of an outbreak. This also means that online options for attending class need to be available for everyone.
This also means getting rid of the dining hall buffets, frozen yogurt machines, and the like. Many are moving to take-out orders.
Hybrid plans are supposed to help reduce class sizes, with many stretching their schedules into Saturdays to offer more classroom time and allow for disinfection between meetings. The University of Texas at Austin, one of the biggest schools emphasizing face-to-face instruction, will limit classes to 40% capacity, for example. The University of California San Diego has announced that 30% of its classes would be in-person.
Those reduced class sizes are a lesson in geometry in themselves. To maintain 6-foot distances, FEMA guidelines call for 113 square feet of personal space between people indoors, while New York State standards for classrooms now require 17 to 22 square feet per student.
At Purdue, where the “Protect Purdue Pledge” will be required of returning students, history professor Dave Atkinson generated some attention on Twitter by displaying a rolling face shield for professors cooked up for the fall.
“Smaller classes, masks, it does reduce the chance of transmission, and it would be foolish not to take every step of that sort,” Bergstrom said. “My feeling is that isn’t enough.”
Professors And Staff
Although COVID-19 has killed college students, including 21-year-old Penn State student Juan Garcia, the disease is most dangerous to older people and people with high-risk conditions.
That puts professors squarely in the crosshairs, endangered by the very people they are trying to teach. The median age of a US tenure-track professor is now 49, with 39% of faculty members 55 or older. That means college campuses intensify the wider threat of the COVID-19 pandemic, deliberately exposing young people — the ones least likely to have symptoms despite an infection — to older, at-risk people.
People who haven’t yet developed any symptoms are responsible for more than 40% of the virus’s spread. And only about 45% of cases early in an infection will develop a fever that could be picked up by the morning temperature checks envisioned in many reopening plans.
“I was 7 years old when FDR died,” said Stanley Fish of the Cardozo School of Law in New York, who is planning to teach a remote class this fall. “I’m sure many administrators — I used to be one — are thinking, Well here’s Fish, he’s 82, he’s in danger of contracting this disease, we could probably do without him.” He sees the trend toward hiring younger, cheaper adjuncts to replace older tenured professors as one likely intensified by the pandemic.
A coalition of professors from 17 Midwestern universities this month released an open letter, warning of the “the almost assured potential to launch a superspreader event that will harm, or even kill, members of our communities,” from campus reopenings. The warning wasn’t just for professors but employees in communities already hit disproportionately hard by the pandemic.
“In a classroom with 40 students who are all regular college-age students, there is a greater potential risk of transmission to that one professor,” Emory’s Bednarczyk said.
Many hybrid plans — like at the University of South Florida and the University of Central Florida — will end classes before Thanksgiving and send students home to take final exams remotely. That exodus is a bid to shrink the overall length of the semester’s exposure time and dodge the height of the flu season on campus.
But Bergstrom worries that could potentially lead to students departing en masse from an infected campus to bring home the virus to older relatives at the Thanksgiving dinner table.
“You need to plan for your family and your community, to keep them safe because there may be an outbreak on campus and you go home,” he said. Then you may be infected and you may not be showing symptoms.”
For safety, students returning home would have to self-isolate in their room for two weeks — a tough sell when you haven’t seen your friends and relatives for weeks.
The CDC came under criticism for seeming to recommend against testing returning students before they arrived in the classroom.
“Testing of all students, faculty and staff for COVID-19 before allowing campus entry (entry testing) has not been systematically studied,” say the guidelines. “Therefore, CDC does not recommend entry testing of all returning students, faculty, and staff.”
That’s ridiculous, Bergstrom and other public health officials said. Obviously college entry testing hasn’t been studied because we are only six months into the pandemic, he argued, adding that for the CDC to rule out something so obvious as checking students before they settle into an outbreak-prone dorm was senseless.
“They've shown a willingness to capitulate to the White House on other things,” Bergstrom said. “I'm concerned that that may have been a motivation.”
Some colleges are ignoring the CDC guidance, like the University of Alabama schools, which have announced they would offer student entry testing.
The CDC’s recommendations do call for testing on a regular basis, looking for people who are asymptomatic or minimally symptomatic. The goal is to stop those people from walking around and spreading further infections.
The University of California San Diego announced that there’d be widespread student testing on campus. The school estimates that if 75% of students are tested monthly, then no more than 10 detectable cases would be on campus before an outbreak was identified. Bergstrom argues that weekly testing might be a good starting point for some institutions, depending on the school, especially those with a plan in place to scale up rapidly if necessary. Others might need to test more frequently.
One way to have that work — without bankrupting schools — would be to “pool” samples where groups of people living on the same floor of a dorm might all have their swabs or spit tested together. Most of the results would come back negative, but if one pool tests positive, then everyone in the pool gets retested. It’s a way to stretch out test supplies.
Many schools are also building their own contact tracing plans, like at Texas A&M and Arizona State University, instead of relying on local health departments. The plans are a recognition that cases of illness are a matter of when, not if, for schools. ●